Objective: To evaluate the surgical feasibility and the long-term anatomic and functional results of a new procedure that uses the endoscopic approach to treat uterovaginal agenesis, known as Rokintansky syndrome.Design: Evaluation of surgical feasibility and recording of clinical data over a 12-month follow-up.Setting: Tertiary referral center for the treatment of female genital malformations.Patient(s): Fifty-two patients with vaginal agenesis.Intervention(s): The laparoscopic version of the Vecchietti method was used to create a neovagina.Main Outcome Measure(s): Anatomic success was defined as a neovagina =<6 cm long, allowing easy introduction of two fingers, within 6 months after corrective surgery. Functional success was considered achieved if the patient reported satisfactory sexual intercourse starting from 6 months after surgery.Result(s): The surgical procedure was performed with no major complications and with 100% anatomic success; functional success was obtained in 98.1% of the study population.Conclusion(s): In patients with Rokitansky syndrome, the laparoscopic approach for creating a neovagina by the Vecchietti method is simple, safe, and effective.